Healthcare Provider Details

I. General information

NPI: 1356531990
Provider Name (Legal Business Name): COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2007
Last Update Date: 11/03/2022
Certification Date: 11/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1019 112TH ST SW
EVERETT WA
98204-4875
US

IV. Provider business mailing address

8609 EVERGREEN WAY
EVERETT WA
98208-2619
US

V. Phone/Fax

Practice location:
  • Phone: 425-551-6521
  • Fax: 425-551-6525
Mailing address:
  • Phone: 425-789-3700
  • Fax: 425-789-3780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License NumberPHAR.CF.00059092
License Number StateWA

VIII. Authorized Official

Name: JOE VESSEY
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 425-789-3700